| NPI | 1316953839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202K00000X Phlebology (Licence: VA 0101033835) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101033835) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2014-06-13 |